Patient Billing Call Center Representative

Description

We are seeking a detail oriented and empathetic Patient Billing Call Center Representative to join our Call Center team. In this role, you will be the primary point of contact for patients with questions about their account balances, patient statements, insurance explanations of benefits (EOBs), payment options, and billing concerns. You will help patients understand what they owe, why they owe it, and how to resolve their balance, while ensuring every interaction is professional, accurate, and compliant.

The ideal candidate is a clear communicator who can translate complex billing and insurance information into plain language, stays calm when patients are frustrated or confused, and takes pride in resolving billing issues the first time whenever possible.

Duties and Responsibilities

• Answer a high volume of inbound patient billing calls promptly, projecting a patient, empathetic, and professional attitude with every interaction.
• Explain patient statements in detail, including charges, adjustments, insurance payments, patient responsibility, and current balance.
• Review and interpret insurance Explanation of Benefits (EOBs) and explain how allowed amounts, deductibles, copays, coinsurance, and denials affect the patient’s balance.
• Identify discrepancies between patient statements, EOBs, and account records, and research or escalate billing errors to the appropriate team.
• Set up payment arrangements, process payments, and discuss available financial assistance or payment plan options in accordance with company policy.
• Document all call activity accurately and thoroughly in the patient account and billing system.
• Follow up on open billing inquiries and escalated issues to ensure timely resolution and patient satisfaction.
• Maintain patient privacy and comply with HIPAA and all company security and compliance standards.
• Meet or exceed call handling, resolution, and quality performance metrics.
• Collaborate with billing, insurance, and clinical team members to ensure accurate account resolution and a seamless patient experience.
• Review denials, accounts receivable, payment posting or intial review of patient statements while not answering calls 

Requirements

• 1–2 years of healthcare experience in a provider or payer setting, such as a hospital, physician practice, dental office, health plan, or medical billing environment.
• Required knowledge of patient statements, billing terminology, and the patient payment cycle.
• Required ability to read and understand insurance Explanation of Benefits (EOBs), including allowed amounts, adjustments, patient responsibility, and denial codes.
• 1+ year of call center or high volume phone experience, preferably in a billing, collections, or customer support role.
• Strong customer service skills with the ability to remain patient and professional in emotionally charged conversations.
• Excellent verbal and written communication skills, with the ability to explain financial information clearly.
• Proficiency with computer systems and the ability to navigate multiple applications while on calls.
• Proficiency in navigating patient portals. Knowledge of Carestack is a plus.
• Strong attention to detail, organizational skills, and math accuracy.
• Knowledge of HIPAA privacy and security requirements.
• High school diploma or equivalent required; coursework or certification in medical billing, coding, or healthcare administration is a plus. Bachelor’s degree is a plus.